NUR 524 EXAM 2 | ALL QUESTIONS AND
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Terms in this set (181)
Normal PMI? In Midclavicular 5th intercostal space
cardiomegaly? In Cardiomegaly displaced to the left
What should you tell your Hold breath
patient to do when
assessing for carotid
bruits?
Closure of AV valves when ventricular pressure
exceeds atrial pressures at beginning of systole
S1
Corresponds with pulse
Best heard at apex
Closure of semilunar valves
Normally split because Aortic valve closes before
Pulmonic valve
Closure pressure on left is 80mmHg compared to 10
S2
on right
Normal for split to widen during inspiration d/t
increased RV filling from negative intrathoracic
pressure
, Transition from rapid to slow ventricular filling in early
diastole. May be normal in children
S3 Best heard with bell
Can be caused by poor systolic dysfunction or poor
myocardial contracility such as CHF
Abnormal late diastolic sound caused by forcible
atrial contraction in the presence of decreased
ventricular compliance
S4 Best heard with bell (Higher pitch than S3)
Caused by diastolic dysfunction or poor myocardial
relaxation (Compliance) such as in recurrent MI,
uncontrolled HTN
Best heard in pulmonic region
RV volume overload such as ASD, and is usually fixed
Pathologic Wide Split S2 with no difference in inspiration or expiration
RV outflow obstruction such as pulmonary stenosis
Delayed RV depolarization such as complete RBBB
Pulmonary HTN as valve closes earlier d/t high
Pathologic Narrow Split pulmonary resistance
S2 Mild-moderate aortic stenosis as closure of valve is
delayed
May occur if one SL valve is missing
(Pulmonary/Aortic atresia or truncus arteriosus)
If both valves close simulatenously as in Pulmonary
Pathologic Single S2
HTN with equal pulmonary and aortic pressures OR in
double outlet single ventricle OR in large VSD with
equal ventricular pressures
Caused by pulmonary valve closure before aortic
Paradoxical split S2 valve closure; Greater with expiration
Occurs in severe aortic stenosis
What are the most Aortic stenosis and mitral regurgitation
common types of
degenerative valvular
heart disease
, Grade 1: Faintly heard with stethoscope, requires
special attention to hear
grade 2: Soft but readily detectable
Intensity Grades of
Grade 3: Prominent but not loud
murmurs
Grade 4: Loud with palpable thrill
Grade 5: Very loud
Grade 6: Audible without use of stethoscope
Blood flow rates
What determines the
Lower and slower flow -> Lower pitch
frequency of a murmur
Higher and faster flow -> Higher pitch
Shape of murmur with respect to its audibility
Murmur configuration Crescendo, decrescendo, flat, or crescendo-
decrescendo
Length of systole or diastole
Duration of murmurs
Mid-systolic, holo-diastolic, pan-systolic
Systolic murmurs begin with or just after S1 and end
before or at S2
Timing of murmurs
Diastolic murmurs begin with or just after S2 and end
before or at S1
Pathology of the atria ventricular or left ventricular
What do murmurs in the
outflow tracts
aortic auscultation area
Aortic stenosis, aortic regurgitation, hypertrophic
indicate
cardiomyopathy
Tend to be quiet
What do murmurs in the
Pathology of the pulmonic valve such as a PDA.
pulmonic area indicate
Further supported if intensity varies with respiration
Murmurs in this area are sometimes more audible if
What do murmurs in Erb's the patient leans forward
point indicate Diastolic murmurs of R atrium and many pulmonic and
aortic murmurs
, Systolic murmurs indicate pulmonic stenosis or
What do murmurs in the tricuspid regurgitation
tricuspid area indicate Diastolic murmurs indicate tricuspid stenosis or
pulmonic regurgitation
Systolic murmurs indicate mitral regurg, aortic outflow
obstruction, or VSD.
What do murmurs in the
Diastolic murmurs indicate mitral stenosis or aortic
mitral/apex area indicate
regurgitation; Mitral stenosis is ONLY heard at apex
and is accompanied by opening snap sound
a systolic ejection-type, harsh crescendo-
decrescendo murmur
Heard best RSB 2nd intercostal space
Aortic Stenosis murmur
Delayed carotid upstroke, narrowed pulse pressure,
systolic thrill
ECG findings: LAE, Left axis deviation, LVH
Ejection systolic murmur with variable intensity; Harsh
crescendo-decrescendo
3rd and 4th LIS down left sternal border
Pulmonary stenosis Heard best at 2nd ICS LSB; S1 and split S2
murmur Increased with valsalva
ECG: Right axis deviation, increased P-wave amplitude
XR: Dilated pulmonary trunk or a main pulmonary
artery (Congenital)
Pansystolic blowing
Laterally displaced, hyper dynamic apical impulse,
Mitral Valve Regurgitation
brisk carotid upstroke
murmur
LVH on ECG and XR
Unchanged with valsalva
Midsystolic to late systolic; Occasionally honking; may
have click and murmur that are intermittent
Mitral valve prolapse Lower L sternal border
murmur Common finding with precuts excavated or scoliosis
Valsalva causes click/murmur to move
Min. ECG changes, inverted T waves II, III, aVF
CORRECT ANSWERS | ALREADY GRADED A+ |
PROFESSOR VERIFIED | LATEST VERSION 2025
Save
Terms in this set (181)
Normal PMI? In Midclavicular 5th intercostal space
cardiomegaly? In Cardiomegaly displaced to the left
What should you tell your Hold breath
patient to do when
assessing for carotid
bruits?
Closure of AV valves when ventricular pressure
exceeds atrial pressures at beginning of systole
S1
Corresponds with pulse
Best heard at apex
Closure of semilunar valves
Normally split because Aortic valve closes before
Pulmonic valve
Closure pressure on left is 80mmHg compared to 10
S2
on right
Normal for split to widen during inspiration d/t
increased RV filling from negative intrathoracic
pressure
, Transition from rapid to slow ventricular filling in early
diastole. May be normal in children
S3 Best heard with bell
Can be caused by poor systolic dysfunction or poor
myocardial contracility such as CHF
Abnormal late diastolic sound caused by forcible
atrial contraction in the presence of decreased
ventricular compliance
S4 Best heard with bell (Higher pitch than S3)
Caused by diastolic dysfunction or poor myocardial
relaxation (Compliance) such as in recurrent MI,
uncontrolled HTN
Best heard in pulmonic region
RV volume overload such as ASD, and is usually fixed
Pathologic Wide Split S2 with no difference in inspiration or expiration
RV outflow obstruction such as pulmonary stenosis
Delayed RV depolarization such as complete RBBB
Pulmonary HTN as valve closes earlier d/t high
Pathologic Narrow Split pulmonary resistance
S2 Mild-moderate aortic stenosis as closure of valve is
delayed
May occur if one SL valve is missing
(Pulmonary/Aortic atresia or truncus arteriosus)
If both valves close simulatenously as in Pulmonary
Pathologic Single S2
HTN with equal pulmonary and aortic pressures OR in
double outlet single ventricle OR in large VSD with
equal ventricular pressures
Caused by pulmonary valve closure before aortic
Paradoxical split S2 valve closure; Greater with expiration
Occurs in severe aortic stenosis
What are the most Aortic stenosis and mitral regurgitation
common types of
degenerative valvular
heart disease
, Grade 1: Faintly heard with stethoscope, requires
special attention to hear
grade 2: Soft but readily detectable
Intensity Grades of
Grade 3: Prominent but not loud
murmurs
Grade 4: Loud with palpable thrill
Grade 5: Very loud
Grade 6: Audible without use of stethoscope
Blood flow rates
What determines the
Lower and slower flow -> Lower pitch
frequency of a murmur
Higher and faster flow -> Higher pitch
Shape of murmur with respect to its audibility
Murmur configuration Crescendo, decrescendo, flat, or crescendo-
decrescendo
Length of systole or diastole
Duration of murmurs
Mid-systolic, holo-diastolic, pan-systolic
Systolic murmurs begin with or just after S1 and end
before or at S2
Timing of murmurs
Diastolic murmurs begin with or just after S2 and end
before or at S1
Pathology of the atria ventricular or left ventricular
What do murmurs in the
outflow tracts
aortic auscultation area
Aortic stenosis, aortic regurgitation, hypertrophic
indicate
cardiomyopathy
Tend to be quiet
What do murmurs in the
Pathology of the pulmonic valve such as a PDA.
pulmonic area indicate
Further supported if intensity varies with respiration
Murmurs in this area are sometimes more audible if
What do murmurs in Erb's the patient leans forward
point indicate Diastolic murmurs of R atrium and many pulmonic and
aortic murmurs
, Systolic murmurs indicate pulmonic stenosis or
What do murmurs in the tricuspid regurgitation
tricuspid area indicate Diastolic murmurs indicate tricuspid stenosis or
pulmonic regurgitation
Systolic murmurs indicate mitral regurg, aortic outflow
obstruction, or VSD.
What do murmurs in the
Diastolic murmurs indicate mitral stenosis or aortic
mitral/apex area indicate
regurgitation; Mitral stenosis is ONLY heard at apex
and is accompanied by opening snap sound
a systolic ejection-type, harsh crescendo-
decrescendo murmur
Heard best RSB 2nd intercostal space
Aortic Stenosis murmur
Delayed carotid upstroke, narrowed pulse pressure,
systolic thrill
ECG findings: LAE, Left axis deviation, LVH
Ejection systolic murmur with variable intensity; Harsh
crescendo-decrescendo
3rd and 4th LIS down left sternal border
Pulmonary stenosis Heard best at 2nd ICS LSB; S1 and split S2
murmur Increased with valsalva
ECG: Right axis deviation, increased P-wave amplitude
XR: Dilated pulmonary trunk or a main pulmonary
artery (Congenital)
Pansystolic blowing
Laterally displaced, hyper dynamic apical impulse,
Mitral Valve Regurgitation
brisk carotid upstroke
murmur
LVH on ECG and XR
Unchanged with valsalva
Midsystolic to late systolic; Occasionally honking; may
have click and murmur that are intermittent
Mitral valve prolapse Lower L sternal border
murmur Common finding with precuts excavated or scoliosis
Valsalva causes click/murmur to move
Min. ECG changes, inverted T waves II, III, aVF
